Endoscopic and pathologic findings of esophagogastroduodenal involvement in Crohn disease in Korea: a prospective single-center cohort study.

IF 4.3 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Inflammatory Bowel Diseases Pub Date : 2026-05-01 DOI:10.1093/ibd/izaf320

Ga Hee Kim, Jihun Kim, Ji Yong Ahn, Sang Hyoung Park, Sung Wook Hwang, Byong Duk Ye, Hwoon-Yong Jung, Suk-Kyun Yang

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Abstract

Background and aims: The characteristics and incidence of esophagogastroduodenal involvement in Crohn disease remain unclear in Korea. In this study we aimed to investigate the prevalence and clinicopathological characteristics of Crohn disease with esophagogastroduodenal involvement.

Methods: A total of 115 patients with Crohn disease who underwent esophagogastroduodenoscopy (EGD) with esophageal, gastric, and duodenal biopsies were prospectively enrolled in 2020-2021 at a tertiary care center. Five specimens were obtained-1 each from the esophagus, gastric body, gastric antrum, duodenal bulb, and second duodenal portion-and histologically reviewed.

Results: The median patient age was 30.0 years, and 74.8% of patients were male. Based on histological features, 56 patients (48.7%) had esophagogastroduodenal involvement (15 esophageal, 44 gastric, 36 duodenal). Notable histopathological findings included non-caseating granulomas in 8 cases (7.0%), focally enhanced gastritis in 38 cases (33.0%), and lymphocytic esophagitis in 13 cases (10.7%). Endoscopic findings suggestive of esophagogastroduodenal involvement were detected in 94 of 115 patients (81.7%). Typical findings included longitudinal or aphthous erosions (esophagus, 3/115 [2.6%]; stomach, 45/115 [39.1%]; duodenum, 19/115 [16.5%]), longitudinal or aphthous ulcers [duodenum: 4/115 (3.5%)], bamboo-joint-like appearance [stomach: 81/115 (70.4%); duodenum: 3/115 (2.6%)], and scar changes [stomach: 2/115 (1.6%); duodenum: 3/115 (2.6%)]. In multivariable analysis, elevated fecal calprotectin (≥100 μg/g) was associated with esophagogastroduodenal involvement in Crohn disease (odds ratio, 6.57; 95% CI, 1.99-21.66; P <.001).

Conclusions: The proportion of esophagogastroduodenal involvement was relatively high among Korean patients with Crohn disease who underwent EGD. In patients with elevated fecal calprotectin, EGD with histopathological examination is recommended to identify esophagogastroduodenal involvement.

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韩国克罗恩病食管胃十二指肠受累的内镜和病理结果：一项前瞻性单中心队列研究。

背景和目的：在韩国，克罗恩病累及食管胃十二指肠的特点和发生率尚不清楚。本研究旨在探讨克罗恩病累及食管胃十二指肠的患病率及临床病理特征。方法：2020-2021年，在一家三级保健中心前瞻性纳入115名接受食管胃十二指肠镜检查（EGD）并进行食管、胃和十二指肠活检的克罗恩病患者。取食管、胃体、胃窦、十二指肠球部和第二十二指肠各1个标本，进行组织学检查。结果：患者中位年龄为30.0岁，男性占74.8%。根据组织学特征，56例（48.7%）患者有食管胃十二指肠受累（食管15例，胃44例，十二指肠36例）。组织学上的主要表现为非干酪化肉芽肿8例（7.0%），局灶性胃炎38例（33.0%），淋巴细胞性食管炎13例（10.7%）。115例患者中有94例（81.7%）的内镜检查结果提示食管胃十二指肠受累。典型表现为纵向或阿弗氏溃疡（食管，3/115[2.6%]；胃，45/115[39.1%]；十二指肠，19/115[16.5%]），纵向或阿弗氏溃疡[十二指肠：4/115(3.5%)]，竹关节样外观[胃：81/115 (70.4%)；十二指肠：3/115(2.6%)，瘢痕改变[胃：2/115 (1.6%)]；十二指肠：3/115(2.6%)]。在多变量分析中，粪钙保护蛋白升高（≥100 μg/g）与克罗恩病食管胃十二指肠受累相关（优势比为6.57；95% CI为1.99 ~ 21.66；P）结论：韩国克罗恩病行EGD的患者中食管胃十二指肠受累的比例相对较高。在粪钙保护蛋白升高的患者中，建议进行EGD和组织病理学检查，以确定食管胃十二指肠是否受累。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Inflammatory Bowel Diseases 医学-胃肠肝病学

CiteScore

9.70

自引率

6.10%

发文量

462

审稿时长

1 months

期刊介绍： Inflammatory Bowel Diseases® supports the mission of the Crohn''s & Colitis Foundation by bringing the most impactful and cutting edge clinical topics and research findings related to inflammatory bowel diseases to clinicians and researchers working in IBD and related fields. The Journal is committed to publishing on innovative topics that influence the future of clinical care, treatment, and research.